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A chronic mucocutaneous infection due to yeasts to the Candida genus can be part of the autoimmune polyglandular syndrome, described as APECS, APECED, SPA type I, CES. The authors describe the case of a young patient affected by mucocutaneous candidiasis, hypoparathyroidism and adrenal insufficiency. Chronic mucocutaneous candidiasis was diagnosed first in early childhood and was followed by the development of hypoparathyroidism (4 yrs) and adrenal insufficiency (5 yrs). The initial lesion of this syndrome is still unknown as the reason of the marked susceptibility to mucocutaneous candidiasis without systemic candidiasis. The treatment of mucocutaneous candidiasis has been improved by the introduction of orally active antifungal drugs as Ketoconazole, first, and fluconazole now.

The Authors report a case of mixed gonadal dysgenesis (DGM), with a mosaic karyotype consisting of two cell lines, one with 45 chromosomes and monosomic X (50%), the other with 46 chromosomes and one Y dicentric chromosome (50%). The patient presents a male phenotype, hypospadias (3rd degree), left cryptorchidism, hypotrophic right testis, short stature and a gonadal asymmetry.

The purpose of this study was to evaluate prolactin secretion in obesity. Basal level of serum prolactin and prolactin response after thyrotropin releasing hormone (TRH) were investigated in 20 obese patients and 20 healthy subjects well matched for age and sex. Obese patients had higher basal levels of serum prolactin than those of healthy subjects. Conversely, no significant difference in serum prolactin concentration was found at any time during TRH stimulating test. However obese patients showed incremental areas of serum prolactin slightly, but not significantly, lower compared to healthy subjects, probably because their basal levels were higher. In conclusion, the present study confirms that prolactin secretion is altered in obese patients. The discrepancy between basal levels and prolactin response during TRH stimulating test seems to indicate a deficiency in the dopaminergic inhibitor system.

Two cases of Graves' (Basedow) dermopathy are reported. In one case pretibial myxoedema was localized on the external surface of the legs down to insteps. In the second case a diffuse form involved both legs and was characterized by wrinkles and peau d'orange appearance at the ankles. In both cases a biopsy confirmed the diagnosis of Graves' dermopathy, showing diffuse areas of amorphus substance infiltrating the derma and fragmentation of collagen fibers. According to the literature, the skin lesions were associated with ophtalmopathy. Thyrostatic therapy affected ophtalmopathy in one of the patients, while pretibial myxoedema regressed in both. The pathogenesis of pretibial myxoedema is not completely clear yet, although dermopathy, along with ophtalmopathy and acropachy, is considered to be an extrathyroidal manifestation of Graves' disease related to bioassayble antibodies anti-TSH receptor. A class of dermopathy-associated antibodies (DAAb) has been identified. It seems to be a reliable biological marker for pretibial myxoedema since it is nearly absent in patients with ophtalmopathy and without dermopathy. Since DAAb does not stimulate human fibroblasts in culture, the role of DAAb in the development of Graves' dermopathy is still to be found.